澳大利亚阿尔弗雷德医院Peter M. Kistler小组在研究中取得进展。他们研究了房颤患者戒酒的影响。相关论文于2020年1月2日发表于国际顶尖学术期刊《新英格兰医学杂志》上。

过量饮酒与房颤和心房重构不良有关，然而，戒酒是否可二级预防房颤尚未清楚。

研究组在澳大利亚的六家医院进行了一项多中心、前瞻性、开放性、随机、对照试验。研究组招募了140名每周至少饮用10份酒（1份约含12g纯酒精），基线时窦性心律出现阵发性或持续性心房颤动的患者。将其按1：1随机分组，其中70名禁止饮酒，70名不加干预。

这140名患者中85%为男性，平均年龄为62岁。戒酒组的每周饮酒量由16.8±7.7份降为2.1±3.7份，降低了87.5%；对照组每周饮酒量则由16.4±6.9份降为13.2±6.5份，降低了19.5%。停药2周后，戒酒组中有37例（53%）患者房颤复发，对照组中有51例（73%）。戒酒组房颤复发前的时间间隔比对照组长，风险比为0.55。随访6个月及以上，戒酒组的房颤负担明显低于对照组。

研究组得出结论，戒酒可减少房颤患者心律失常的复发。

附：英文原文

Title: Alcohol Abstinence in Drinkers with Atrial Fibrillation

Author: Aleksandr Voskoboinik, M.B., B.S., Ph.D.,, Jonathan M. Kalman, M.B., B.S., Ph.D.,, Anurika De Silva, Ph.D.,, Thomas Nicholls, M.B., B.S.,, Benedict Costello, M.B., B.S.,, Shane Nanayakkara, M.B., B.S.,, Sandeep Prabhu, M.B., B.S., Ph.D.,, Dion Stub, M.B., B.S., Ph.D.,, Sonia Azzopardi, R.N.,, Donna Vizi, R.N.,, Geoffrey Wong, M.B., B.S.,, Chrishan Nalliah, M.B., B.S.,, Hariharan Sugumar, M.B., B.S.,, Michael Wong, M.B., B.S., Ph.D.,, Emily Kotschet, M.B., B.S.,, David Kaye, M.B., B.S., Ph.D.,, Andrew J. Taylor, M.B., B.S., Ph.D.,, and Peter M. Kistler, M.B., B.S., Ph.D.

Issue&Volume: 2020-01-01

Abstract:

BACKGROUND

Excessive alcohol consumption is associated with incident atrial fibrillation and adverse atrial remodeling; however, the effect of abstinence from alcohol on secondary prevention of atrial fibrillation is unclear.

METHODS
We conducted a multicenter, prospective, open-label, randomized, controlled trial at six hospitals in Australia. Adults who consumed 10 or more standard drinks (with 1 standard drink containing approximately 12 g of pure alcohol) per week and who had paroxysmal or persistent atrial fibrillation in sinus rhythm at baseline were randomly assigned in a 1:1 ratio to either abstain from alcohol or continue their usual alcohol consumption. The two primary end points were freedom from recurrence of atrial fibrillation (after a 2-week “blanking period”) and total atrial fibrillation burden (proportion of time in atrial fibrillation) during 6 months of follow-up.

RESULTS
Of 140 patients who underwent randomization (85% men; mean [±SD] age, 62±9 years), 70 were assigned to the abstinence group and 70 to the control group. Patients in the abstinence group reduced their alcohol intake from 16.8±7.7 to 2.1±3.7 standard drinks per week (a reduction of 87.5%), and patients in the control group reduced their alcohol intake from 16.4±6.9 to 13.2±6.5 drinks per week (a reduction of 19.5%). After a 2-week blanking period, atrial fibrillation recurred in 37 of 70 patients (53%) in the abstinence group and in 51 of 70 patients (73%) in the control group. The abstinence group had a longer period before recurrence of atrial fibrillation than the control group (hazard ratio, 0.55; 95% confidence interval, 0.36 to 0.84; P=0.005). The atrial fibrillation burden over 6 months of follow-up was significantly lower in the abstinence group than in the control group (median percentage of time in atrial fibrillation, 0.5% [interquartile range, 0.0 to 3.0] vs. 1.2% [interquartile range, 0.0 to 10.3]; P=0.01).

CONCLUSIONS
Abstinence from alcohol reduced arrhythmia recurrences in regular drinkers with atrial fibrillation. 

DOI: 10.1056/NEJMoa1817591

Source: https://www.nejm.org/doi/full/10.1056/NEJMoa1817591